MEDICARE: MISS FERNANDA N. DA SILVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A65096	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GR0078350	OTHER	AR	MEDICAL

General Provider Information

NPI Number	:	1578593778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS FERNANDA N. DA SILVA M.D.

Provider Business Mailing Address
First Line	:	7248 S LAND PARK DR
Second Line	:	SUITE 205
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3660
Country	:	US
Telephone Number	:	916-392-4000
Fax Number	:	916-392-7215

Provider Business Practice Location Address
First Line	:	7248 S LAND PARK DR
Second Line	:	SUITE 205
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3660
Country	:	US
Telephone Number	:	916-392-4000
Fax Number	:	916-392-7215

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	09/20/2012

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